Genetic polymorphisms account for differences in metabolism, including:
- A. Poor metabolizers, who lack a working enzyme
- B. Intermediate metabolizers, who have one working, wild-type allele and one mutant
- C. Extensive metabolizers, with two normally functioning alleles
- D. All of the above
Correct Answer: D
Rationale: All listed phenotypes (A-C) result from genetic polymorphisms affecting drug metabolism, making D correct.
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Which of the following statements about leukotriene pathway inhibitors in
- A. They are more potent anti-inflammatory agents than corticosteroids
- B. Have less side effects than corticosteroids
- C. Are contraindicated in children below 10 years of age
- D. Have no role in aspirin induced asthma
Correct Answer: B
Rationale: Leukotriene inhibitors have fewer side effects than corticosteroids.
After administering a medication, for what would the nurse assess the patient?
- A. Drug effects
- B. Allergies
- C. Pregnancy
- D. Preexisting conditions
Correct Answer: A
Rationale: After the medication is administered, the nurse assesses the patient for drug affects, both therapeutic and adverse. The nurse would assess the patient for allergies, preexisting conditions, and pregnancy before administering a medication.
The safest drug to use to treat pregnant women with deep vein thrombosis is:
- A. Low-molecular-weight heparin
- B. Warfarin
- C. Aspirin
- D. Heparin
Correct Answer: D
Rationale: Heparin is safest in pregnancy as it doesn't cross the placenta, unlike warfarin (B, teratogenic); LMWH is also safe but not listed as 'heparin.'
A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
- A. Antihistamines
- B. Analgesics
- C. Antibiotics
- D. Oral contraceptives
Correct Answer: D
Rationale: St. John's wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John's wort without known adverse effects.
Isosorbide dinitrate is prescribed for a patient with chronic stable angina. This drug is administered twice daily, but the schedule is 7 a.m. and 2 p.m. because:
- A. It is a long-acting drug with potential for toxicity.
- B. Nitrate tolerance can develop.
- C. Orthostatic hypotension is a common adverse effect.
- D. It must be taken with milk or food.
Correct Answer: B
Rationale: A nitrate-free interval (e.g., after 2 p.m.) prevents tolerance.